Loading…

Fast magnetic resonance imaging of the knee using a parallel acquisition technique (mSENSE): a prospective performance evaluation

The performance of a magnetic resonance (MR) imaging strategy that uses multiple receiver coil elements and integrated parallel imaging techniques (iPAT) in traumatic and degenerative disorders of the knee and to compare this technique with a standard MR imaging protocol was evaluated. Ninety patien...

Full description

Saved in:
Bibliographic Details
Published in:European radiology 2006-08, Vol.16 (8), p.1659-1666
Main Authors: Kreitner, Karl-Friedrich, Romaneehsen, Bernd, Krummenauer, Frank, Oberholzer, Katja, Müller, Lars Peter, Düber, Christoph
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c358t-fa9b27a589699412984f5f48d3a0336ba4f25fe452fece27ee95a0a1994393833
cites cdi_FETCH-LOGICAL-c358t-fa9b27a589699412984f5f48d3a0336ba4f25fe452fece27ee95a0a1994393833
container_end_page 1666
container_issue 8
container_start_page 1659
container_title European radiology
container_volume 16
creator Kreitner, Karl-Friedrich
Romaneehsen, Bernd
Krummenauer, Frank
Oberholzer, Katja
Müller, Lars Peter
Düber, Christoph
description The performance of a magnetic resonance (MR) imaging strategy that uses multiple receiver coil elements and integrated parallel imaging techniques (iPAT) in traumatic and degenerative disorders of the knee and to compare this technique with a standard MR imaging protocol was evaluated. Ninety patients with suspected internal derangements of the knee joint prospectively underwent MR imaging at 1.5 T. For signal detection, a 6-channel array coil was used. All patients were investigated with a standard imaging protocol consisting of different turbo spin-echo sequences proton density (PD), T2-weighted turbo spin echo (TSE) with and without fat suppression) in three imaging planes. All sequences were repeated with an integrated parallel acquisition technique (iPAT) using the modified sensitivity encoding (mSENSE) algorithm with an acceleration factor of 2. Two radiologists independently evaluated and scored all images with regard to overall image quality, artefacts and pathologic findings. Agreement of the parallel ratings between readers and imaging techniques, respectively, was evaluated by means of pairwise kappa coefficients that were stratified for the area of evaluation. Agreement between the parallel readers for both the iPAT imaging and the conventional technique, respectively, as well as between imaging techniques was found encouraging with inter-observer kappa values ranging between 0.78 and 0.98 for both imaging techniques, and the inter-method kappa values ranging between 0.88 and 1.00 for both clinical readers. All pathological findings (e.g. occult fractures, meniscal and cruciate ligament tears, torn and interpositioned Hoffa's cleft, cartilage damage) were detected by both techniques with comparable performance. The use of iPAT lead to a 48% reduction of acquisition time compared with standard technique. Parallel imaging using mSENSE proved to be an efficient and economic tool for fast musculoskeletal MR imaging of the knee joint with comparable diagnostic performance to conventional MR imaging.
doi_str_mv 10.1007/s00330-006-0288-0
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68621381</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68621381</sourcerecordid><originalsourceid>FETCH-LOGICAL-c358t-fa9b27a589699412984f5f48d3a0336ba4f25fe452fece27ee95a0a1994393833</originalsourceid><addsrcrecordid>eNqFkU9LHTEUxUNR6vO1H6AbCQjSLsbe_JmZpLsiT1sQXWjXIS_eaHQm80xmBJf95s34HhS66erC5XcO955DyCcGpwyg_ZoBhIAKoKmAK1XBO7JgUvCKgZJ7ZAFaqKrVWh6Qw5wfAUAz2b4nB6xphWiUWJDf5zaPtLf3EcfgaMI8RBsd0lB2Id7TwdPxAelTRKRTnjeWbmyyXYcdte55CjmMYYh0RPcQw_OE9HN_s7q6WX35NqNpyBt0Y3hBusHkh9S_2eOL7SY7Cz-QfW-7jB93c0l-na9uz35Ul9cXP8--X1ZO1GqsvNVr3tpa6aY8xLhW0tdeqjthSwjN2krPa4-y5h4d8hZR1xYsK7AoMQixJCdb33JSuTKPpg_ZYdfZiMOUTaMazoRi_wWZlrXQDS_g8T_g4zClWJ4wgvFWlhIKuSRsS7kSRU7ozSaVcNOrYWDmGs22RlNqNHONBormaOc8rXu8-6vY9Sb-ACaKmFE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3127408445</pqid></control><display><type>article</type><title>Fast magnetic resonance imaging of the knee using a parallel acquisition technique (mSENSE): a prospective performance evaluation</title><source>Springer Nature</source><creator>Kreitner, Karl-Friedrich ; Romaneehsen, Bernd ; Krummenauer, Frank ; Oberholzer, Katja ; Müller, Lars Peter ; Düber, Christoph</creator><creatorcontrib>Kreitner, Karl-Friedrich ; Romaneehsen, Bernd ; Krummenauer, Frank ; Oberholzer, Katja ; Müller, Lars Peter ; Düber, Christoph</creatorcontrib><description>The performance of a magnetic resonance (MR) imaging strategy that uses multiple receiver coil elements and integrated parallel imaging techniques (iPAT) in traumatic and degenerative disorders of the knee and to compare this technique with a standard MR imaging protocol was evaluated. Ninety patients with suspected internal derangements of the knee joint prospectively underwent MR imaging at 1.5 T. For signal detection, a 6-channel array coil was used. All patients were investigated with a standard imaging protocol consisting of different turbo spin-echo sequences proton density (PD), T2-weighted turbo spin echo (TSE) with and without fat suppression) in three imaging planes. All sequences were repeated with an integrated parallel acquisition technique (iPAT) using the modified sensitivity encoding (mSENSE) algorithm with an acceleration factor of 2. Two radiologists independently evaluated and scored all images with regard to overall image quality, artefacts and pathologic findings. Agreement of the parallel ratings between readers and imaging techniques, respectively, was evaluated by means of pairwise kappa coefficients that were stratified for the area of evaluation. Agreement between the parallel readers for both the iPAT imaging and the conventional technique, respectively, as well as between imaging techniques was found encouraging with inter-observer kappa values ranging between 0.78 and 0.98 for both imaging techniques, and the inter-method kappa values ranging between 0.88 and 1.00 for both clinical readers. All pathological findings (e.g. occult fractures, meniscal and cruciate ligament tears, torn and interpositioned Hoffa's cleft, cartilage damage) were detected by both techniques with comparable performance. The use of iPAT lead to a 48% reduction of acquisition time compared with standard technique. Parallel imaging using mSENSE proved to be an efficient and economic tool for fast musculoskeletal MR imaging of the knee joint with comparable diagnostic performance to conventional MR imaging.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-006-0288-0</identifier><identifier>PMID: 16733683</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Adolescent ; Adult ; Aged ; Algorithms ; Child ; Damage detection ; Female ; Fractures ; Humans ; Image acquisition ; Image Interpretation, Computer-Assisted ; Image quality ; Imaging techniques ; Injuries ; Joints (anatomy) ; Knee ; Knee Injuries - diagnosis ; Magnetic resonance imaging ; Magnetic Resonance Imaging - instrumentation ; Magnetic Resonance Imaging - methods ; Male ; Medical imaging ; Meniscus ; Middle Aged ; Performance evaluation ; Prospective Studies ; Proton density (concentration) ; Sensitivity analysis ; Sensitivity and Specificity ; Signal detection</subject><ispartof>European radiology, 2006-08, Vol.16 (8), p.1659-1666</ispartof><rights>Springer-Verlag 2006.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c358t-fa9b27a589699412984f5f48d3a0336ba4f25fe452fece27ee95a0a1994393833</citedby><cites>FETCH-LOGICAL-c358t-fa9b27a589699412984f5f48d3a0336ba4f25fe452fece27ee95a0a1994393833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16733683$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kreitner, Karl-Friedrich</creatorcontrib><creatorcontrib>Romaneehsen, Bernd</creatorcontrib><creatorcontrib>Krummenauer, Frank</creatorcontrib><creatorcontrib>Oberholzer, Katja</creatorcontrib><creatorcontrib>Müller, Lars Peter</creatorcontrib><creatorcontrib>Düber, Christoph</creatorcontrib><title>Fast magnetic resonance imaging of the knee using a parallel acquisition technique (mSENSE): a prospective performance evaluation</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><description>The performance of a magnetic resonance (MR) imaging strategy that uses multiple receiver coil elements and integrated parallel imaging techniques (iPAT) in traumatic and degenerative disorders of the knee and to compare this technique with a standard MR imaging protocol was evaluated. Ninety patients with suspected internal derangements of the knee joint prospectively underwent MR imaging at 1.5 T. For signal detection, a 6-channel array coil was used. All patients were investigated with a standard imaging protocol consisting of different turbo spin-echo sequences proton density (PD), T2-weighted turbo spin echo (TSE) with and without fat suppression) in three imaging planes. All sequences were repeated with an integrated parallel acquisition technique (iPAT) using the modified sensitivity encoding (mSENSE) algorithm with an acceleration factor of 2. Two radiologists independently evaluated and scored all images with regard to overall image quality, artefacts and pathologic findings. Agreement of the parallel ratings between readers and imaging techniques, respectively, was evaluated by means of pairwise kappa coefficients that were stratified for the area of evaluation. Agreement between the parallel readers for both the iPAT imaging and the conventional technique, respectively, as well as between imaging techniques was found encouraging with inter-observer kappa values ranging between 0.78 and 0.98 for both imaging techniques, and the inter-method kappa values ranging between 0.88 and 1.00 for both clinical readers. All pathological findings (e.g. occult fractures, meniscal and cruciate ligament tears, torn and interpositioned Hoffa's cleft, cartilage damage) were detected by both techniques with comparable performance. The use of iPAT lead to a 48% reduction of acquisition time compared with standard technique. Parallel imaging using mSENSE proved to be an efficient and economic tool for fast musculoskeletal MR imaging of the knee joint with comparable diagnostic performance to conventional MR imaging.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Child</subject><subject>Damage detection</subject><subject>Female</subject><subject>Fractures</subject><subject>Humans</subject><subject>Image acquisition</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Image quality</subject><subject>Imaging techniques</subject><subject>Injuries</subject><subject>Joints (anatomy)</subject><subject>Knee</subject><subject>Knee Injuries - diagnosis</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - instrumentation</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Meniscus</subject><subject>Middle Aged</subject><subject>Performance evaluation</subject><subject>Prospective Studies</subject><subject>Proton density (concentration)</subject><subject>Sensitivity analysis</subject><subject>Sensitivity and Specificity</subject><subject>Signal detection</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNqFkU9LHTEUxUNR6vO1H6AbCQjSLsbe_JmZpLsiT1sQXWjXIS_eaHQm80xmBJf95s34HhS66erC5XcO955DyCcGpwyg_ZoBhIAKoKmAK1XBO7JgUvCKgZJ7ZAFaqKrVWh6Qw5wfAUAz2b4nB6xphWiUWJDf5zaPtLf3EcfgaMI8RBsd0lB2Id7TwdPxAelTRKRTnjeWbmyyXYcdte55CjmMYYh0RPcQw_OE9HN_s7q6WX35NqNpyBt0Y3hBusHkh9S_2eOL7SY7Cz-QfW-7jB93c0l-na9uz35Ul9cXP8--X1ZO1GqsvNVr3tpa6aY8xLhW0tdeqjthSwjN2krPa4-y5h4d8hZR1xYsK7AoMQixJCdb33JSuTKPpg_ZYdfZiMOUTaMazoRi_wWZlrXQDS_g8T_g4zClWJ4wgvFWlhIKuSRsS7kSRU7ozSaVcNOrYWDmGs22RlNqNHONBormaOc8rXu8-6vY9Sb-ACaKmFE</recordid><startdate>20060801</startdate><enddate>20060801</enddate><creator>Kreitner, Karl-Friedrich</creator><creator>Romaneehsen, Bernd</creator><creator>Krummenauer, Frank</creator><creator>Oberholzer, Katja</creator><creator>Müller, Lars Peter</creator><creator>Düber, Christoph</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20060801</creationdate><title>Fast magnetic resonance imaging of the knee using a parallel acquisition technique (mSENSE): a prospective performance evaluation</title><author>Kreitner, Karl-Friedrich ; Romaneehsen, Bernd ; Krummenauer, Frank ; Oberholzer, Katja ; Müller, Lars Peter ; Düber, Christoph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c358t-fa9b27a589699412984f5f48d3a0336ba4f25fe452fece27ee95a0a1994393833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Child</topic><topic>Damage detection</topic><topic>Female</topic><topic>Fractures</topic><topic>Humans</topic><topic>Image acquisition</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Image quality</topic><topic>Imaging techniques</topic><topic>Injuries</topic><topic>Joints (anatomy)</topic><topic>Knee</topic><topic>Knee Injuries - diagnosis</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - instrumentation</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Meniscus</topic><topic>Middle Aged</topic><topic>Performance evaluation</topic><topic>Prospective Studies</topic><topic>Proton density (concentration)</topic><topic>Sensitivity analysis</topic><topic>Sensitivity and Specificity</topic><topic>Signal detection</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kreitner, Karl-Friedrich</creatorcontrib><creatorcontrib>Romaneehsen, Bernd</creatorcontrib><creatorcontrib>Krummenauer, Frank</creatorcontrib><creatorcontrib>Oberholzer, Katja</creatorcontrib><creatorcontrib>Müller, Lars Peter</creatorcontrib><creatorcontrib>Düber, Christoph</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing &amp; Allied Health Source</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies &amp; Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest advanced technologies &amp; aerospace journals</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kreitner, Karl-Friedrich</au><au>Romaneehsen, Bernd</au><au>Krummenauer, Frank</au><au>Oberholzer, Katja</au><au>Müller, Lars Peter</au><au>Düber, Christoph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fast magnetic resonance imaging of the knee using a parallel acquisition technique (mSENSE): a prospective performance evaluation</atitle><jtitle>European radiology</jtitle><addtitle>Eur Radiol</addtitle><date>2006-08-01</date><risdate>2006</risdate><volume>16</volume><issue>8</issue><spage>1659</spage><epage>1666</epage><pages>1659-1666</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>The performance of a magnetic resonance (MR) imaging strategy that uses multiple receiver coil elements and integrated parallel imaging techniques (iPAT) in traumatic and degenerative disorders of the knee and to compare this technique with a standard MR imaging protocol was evaluated. Ninety patients with suspected internal derangements of the knee joint prospectively underwent MR imaging at 1.5 T. For signal detection, a 6-channel array coil was used. All patients were investigated with a standard imaging protocol consisting of different turbo spin-echo sequences proton density (PD), T2-weighted turbo spin echo (TSE) with and without fat suppression) in three imaging planes. All sequences were repeated with an integrated parallel acquisition technique (iPAT) using the modified sensitivity encoding (mSENSE) algorithm with an acceleration factor of 2. Two radiologists independently evaluated and scored all images with regard to overall image quality, artefacts and pathologic findings. Agreement of the parallel ratings between readers and imaging techniques, respectively, was evaluated by means of pairwise kappa coefficients that were stratified for the area of evaluation. Agreement between the parallel readers for both the iPAT imaging and the conventional technique, respectively, as well as between imaging techniques was found encouraging with inter-observer kappa values ranging between 0.78 and 0.98 for both imaging techniques, and the inter-method kappa values ranging between 0.88 and 1.00 for both clinical readers. All pathological findings (e.g. occult fractures, meniscal and cruciate ligament tears, torn and interpositioned Hoffa's cleft, cartilage damage) were detected by both techniques with comparable performance. The use of iPAT lead to a 48% reduction of acquisition time compared with standard technique. Parallel imaging using mSENSE proved to be an efficient and economic tool for fast musculoskeletal MR imaging of the knee joint with comparable diagnostic performance to conventional MR imaging.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>16733683</pmid><doi>10.1007/s00330-006-0288-0</doi><tpages>8</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0938-7994
ispartof European radiology, 2006-08, Vol.16 (8), p.1659-1666
issn 0938-7994
1432-1084
language eng
recordid cdi_proquest_miscellaneous_68621381
source Springer Nature
subjects Adolescent
Adult
Aged
Algorithms
Child
Damage detection
Female
Fractures
Humans
Image acquisition
Image Interpretation, Computer-Assisted
Image quality
Imaging techniques
Injuries
Joints (anatomy)
Knee
Knee Injuries - diagnosis
Magnetic resonance imaging
Magnetic Resonance Imaging - instrumentation
Magnetic Resonance Imaging - methods
Male
Medical imaging
Meniscus
Middle Aged
Performance evaluation
Prospective Studies
Proton density (concentration)
Sensitivity analysis
Sensitivity and Specificity
Signal detection
title Fast magnetic resonance imaging of the knee using a parallel acquisition technique (mSENSE): a prospective performance evaluation
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T12%3A50%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Fast%20magnetic%20resonance%20imaging%20of%20the%20knee%20using%20a%20parallel%20acquisition%20technique%20(mSENSE):%20a%20prospective%20performance%20evaluation&rft.jtitle=European%20radiology&rft.au=Kreitner,%20Karl-Friedrich&rft.date=2006-08-01&rft.volume=16&rft.issue=8&rft.spage=1659&rft.epage=1666&rft.pages=1659-1666&rft.issn=0938-7994&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-006-0288-0&rft_dat=%3Cproquest_cross%3E68621381%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c358t-fa9b27a589699412984f5f48d3a0336ba4f25fe452fece27ee95a0a1994393833%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3127408445&rft_id=info:pmid/16733683&rfr_iscdi=true